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Global Age Watch Index (GAWI), developed with the United Nations Fund for Population and Development, ranks India 73rd out of 91 countries in elderly care.

It is estimated that India has around 90 million elderly and by 2050, this number is expected to rise to 315 million. Life expectancy in India has increased from 42 years in 1960 to over 65 years at present.* According to KPMG ASSOCHAM Report, ‘Old age security: doing the right thing for our elders’, launched today, longevity is laudable as an achievement in developing countries but it often leads to social and economic pressures on formal and informal care network along with the government.

The report attempts to capture the prominent trends of the elderly in India, initiatives taken by the Government for this segment and also outlines a possible roadmap for the long-term care of the aged. It highlights the fact that while the demand for better healthcare for the elderly is expected to increase rapidly, lack of incentives for getting into elderly care is leading to an ever increasing gap between the supply and demand for elderly care. Disease management, as a concept, is relatively nascent in the country with healthcare being largely reactive in nature. The goal of disease management is to increase focus on preventive care to minimise the incidence of hospitalization and thereby reduce the overall pressure on the healthcare system.

Speaking at the launch of the report, Shashwat Sharma, Partner – Financial Services and Insurance, KPMG in India said, “The elderly face a lot of challenges in terms of their health and well-being. This issue is more daunting for senior people below the poverty line in rural areas as most of the old-age homes, institutional support and medical care are currently focused on urban areas. We believe there is a clear need emerging for a range of solutions for elderly care like an increase in the supply of geriatric facilities and a greater co-ordination between various implementing bodies. The use of innovative delivery models that aim to ensure elderly care and improved medical devices is expected to change the approach to elderly planning and care and provide wide ranging solution for the overall security of the elderly”.

The survey revealed that financial and health problems coupled with living alone emerged as the top three fears of the elderly. Most of the elderly also preferred living with their children rather than shifting to specialized senior citizen homes, even though better medical facilities might be on offer in specialized housing societies. More than half the elderly (69%), ranked social protection as a parameter where they have the most need for intervention. Overall, the survey highlighted the need for security on five varied dimensions — financial security, physical security, emotional security, social security and family security.

Addressing the media at the launch of the report, D S Rawat, Secretary General, ASSOCHAM said, “The object of social security is to provide livelihood to those who cannot earn their livelihood for chronic or temporary reasons. Older persons need social security as they cannot work and earn due to the age factor. Therefore, subsidized insurance schemes need to be enlarged to cover all sections, especially the unorganized sector linked to welfare funds.”
“ASSOCHAM in partnership with KPMG brings to you the knowledge report, ‘Old Age Security - doing the right thing for our Elders’ throwing light on prominent trends, healthcare sector and the key drivers in old age security. ASSOCHAM acknowledges the contribution of the KPMG in India and ASSOCHAM teams in creating this knowledge report for easy understanding and as a ready reference book”, he added.

The government of India has initiated welfare programs over the past two decades to enable better provision of care for the elderly such as the India Gandhi Old Age Pension Scheme and the National rural health mission, as well as programmes to provide tools for financial security in the twilight years such as the National Pension Scheme. Recently, the Government also brought about the Maintenance and welfare of Parents and Senior Citizens Act, 2007 to provide legislative support for care of the elderly.

However, despite various schemes introduced by the Government, a Universal Health Care system has been proposed. To facilitate effectiveness of UHC, it is important to identify different segments within the elderly who need subsidization to focus the overall efforts of the government. The report recommends looking at different segments such as the economically dependent and economically independent in the rural–urban areas. It also emphasizes on disease management for this segment by creating a special fund which will pay for the preventive care expenditure.

Poor and economically dependent senior citizens in the rural and urban areas have an urgent need for support in terms of UHC which will provide for both inpatient and outpatient treatments across secondary and tertiary care. The economically independent elderly would need support across the five elements of financial, emotional, social, physical and family security for a comprehensive support system.

There are multiple industries which are slowly bringing out products for elderly care such as annuity offerings from Life Insurance companies, specialized health insurance products, Reverse Mortgage from Banks and specialized housing from real estate players. However, given the limited role being played by each player, there is a need for an aggregator to consolidate all these offerings and to provide a single window solution to the elderly.

To enable the development of such aggregators, it is important to have support in terms of tax incentives and regulatory enablement which would promote the suppliers of such services to bring more focus on retirement savings as well as to encourage individuals to put away more funds for their twilight years.

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